Long-term effects of sleeve gastrectomy on metabolic parameters and obstructive sleep apnea resolution: a prospective observational study.

BACKGROUND

Sleeve gastrectomy (SG) has emerged as the most effective metabolic and bariatric surgical intervention for managing obesity-related complications. The objective of this study is to investigate the long-term effects of SG on cardiometabolic parameters and the resolution of obstructive sleep apnea (OSA) five-year post-surgery.

METHODS

This prospective cohort study conducted between (2018–2023) at our institution and included patients aged 18 to 60 years who underwent SG. We compared anthropometric, glycemic, blood pressure (BP), lipid profile and sleep apnea parameters at baseline and 5 years after surgery.

RESULTS

A total of 48 patients included in the study, 70% were female with mean age 35.6 years. Patients achieved significant body mass index reduction from 45.8 ± 8.1 kg/m2 at baseline to 30.5 ± 6.82 kg/m² at 5 years with a excess weight loss percentage of 69.14%. Both waist and neck circumferences significantly decreased (P = 0.00 for each). Cardiometabolic parameters including blood pressure (BP), fasting blood glucose, hemoglobin A1c (HbA1c), homeostatic model assessment for insulin resistance (HOMA-IR), triglyceride, and high-density lipoprotein (HDL) showed significant improvements (P = 0.000 for all). However, changes in total cholesterol and low-density lipoprotein (LDL) did not reach statistical significance. The STOP-BANG questionnaire score decreased from 4.3 at baseline to 1.2 at 5 years. Similarly, the Apnea-Hypopnea Index significantly decreased from 22 at baseline to 6 five years post-surgery. Remission rates were 64.3% for hypertension (HTN), 71.4% for type 2 diabetes(T2DM), 58.1% for dyslipidemia, and 80% for OSA. Approximately 31% of our cohort experienced weight regain; however, they still retained their cardiometabolic improvements and OSA benefits five years after SG.

CONCLUSION

The current study confirms that SG has a significant long-term impact on both cardiometabolic health with partial or even complete resolution of OSA. Clinical trial registration: ISRCTN62397779.